NPIMap

Individual provider Active NPI

Justin Brewer

  • Surgery Physician
  • Ypsilanti, MI
National Provider Identifier
1417416298
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MED-PHYS-LIC-136211 Issued in MT
Practice address
5333 McAuley Drive Suite 2115
Ypsilanti, MI 48197
Phone
(734) 712-3971
NPI assigned
Mar 19, 2019
Last updated
Jun 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X MED-PHYS-LIC-136211 MT Primary

Addresses

Primary practice location

5333 McAuley Drive Suite 2115
Ypsilanti, MI 48197

Mailing address

911 Woodland Dr
Bozeman, MT 59718-2763

Other practice location 1

2900 12th Ave N Ste 355
Billings, MT 59101-7506
Phone (406) 238-6470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715002964 MT Practitioner - General Surgery 6406182849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates, PCGroup PAC ID 5597780791, 9 clinicians

Practice addresses (Care Compare)

2900 12TH Ave N 355
Billings, MT 59101-7590
Phone (406) 238-6470

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-136211MTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Association CurrentSince Nov 1, 2025 Accepting new patients
Surgical Associates, PC CurrentSince Aug 1, 2024 Accepting new patients
Memorial Hospital Association CurrentSince Nov 1, 2025 Accepting new patients
SCL Health Montana Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2900 12th Ave N
Ste 355W
Billings, MT 59101
Phone (406) 238-6470

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1417416298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 WOODLAND DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DRIVE SUITE 2115",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-712-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 12th Ave N Ste 355",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591017506",
            "country_code": "US",
            "telephone_number": "406-238-6470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "MED-PHYS-LIC-136211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.